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Abortion, Poverty, Contraception, and Promiscuity

There has been much attention given to the latest report that abortions have fallen to their lowest rate in 40 years. The rate of below 17 abortions per 1,000 women ages 15-44 is nearly half of the rate at its peak in 1980. Discussions in the wake of the report have focused on causation, an almost-impossible task given the complexity of the phenomenon of abortion. Isolating causes is certainly not possible, and it seems more reasonable to suggest that more-successful contraception and a more negative public attitude toward the morality of abortion have both contributed to the decline. The question of whether state-level legal restrictions on abortion make any difference is hotly disputed; since these restrictions ordinarily are passed in states where abortions are geographically less available and where the general moral culture is more anti-abortion, it would be hard to know how to separate out these factors.

I want to put these numbers in some larger perspective, by diving more deeply into the statistics about abortion. To me, these raise questions about the level to which one could drive down this abortion rate; as with our economic analysis, a focus on up-or-down trend numbers often obscures the larger phenomenon.

The first issue is the relationship of economic security to abortion. (All data here is taken from Guttmacher’s fact sheets from their last survey.) 69% of abortions are for women at 200% of poverty level or below. The abortion rate for women at or below poverty is 52 per 1,000 women (15-44), but their “unintended birth” rate is also very high: 70 per 1,000. Thus, the “unintended pregnancy” rate for poor women is 137 per 1,000 – a number near six times high than that of 200%+ poverty women (26). Guttmacher actually reports that the higher income group is more likely to choose abortion for an unintended pregnancy… but of course is dramatically less likely to have an unintended pregnancy in the first place. These numbers, which really show dramatic group differences, suggest that poverty and abortion must be addressed together. However, the number do NOT suggest that, if women had more economic resources, they would be more likely to choose life. (Otherwise, we would expect a higher ratio of abortions for poor women.) Rather, they suggest that with economic security, women might be less likely to get pregnant in the first place. Indeed, if women below the poverty level continued to get pregnant at the same rate as currently, but had abortions at the rate of wealthier women, the rate of “unintended births” to those in poverty would be over 100 per 1,000!

The above numbers at least raise pragmatic questions about those whose strategy for addressing the problem is to ask, persuade, or coerce women to keep their babies. However, they also raise questions for the common solution proferred by the other side: contraception is the answer. Guttmacher, a very pro-contraception source, notes that the majority (54%) of women seeking abortions report using it either correctly or incorrectly. Of those not using contraception, Guttmacher reports that “About half of unintended pregnancies occur among the 11% of women who are at risk but are not using contraceptives. Most of these women have practiced contraception in the past.” That last sentence is significant; it calls into question the extent to which education and access are really the issue. Guttmacher even tries to determine reasons why women were not using contraception, and a mix of reasons follow, including “unplanned sex” and a perception of “low risk.” What Guttmacher doesn’t ask is how often this is a case of an unintended pregnancy in a non-stable relationship situation. They do report significantly (without poverty numbers): “More than one in 10 single men indicated that they did not know about the pregnancy until after the child was born. Among single men aware of the pregnancy, nearly three out of four births were reported as unintended.” If abortion is strongly connected to the unintended pregnancy rate, and unintended pregnancies are far more frequently reported by in situations of singleness, then perhaps monogamy matters. The question for the contraception side is how you drive down the “unintended pregnancy” rate in light of risky sexual behavior. As they note, the trend for “unintended pregnancy” among poor women is not downward – anything but! In 1994, the unintended pregnancy rate among women with incomes below the federal poverty line was 88 per 1,000 women aged 15–44; it rose to 120 in 2001 and 137 in 2008—a 56% increase since 1994. At the same time, the rate among higher –income women (those with incomes at or above 200% of the poverty line) fell from 34 in 1994 to 28 in 2001 and 26 in 2008—a 24% decrease.” Even if you increase effective contraception use, an increase in risky sexual behaviors will potentially offset this. The key number that would be helpful to know would be the abortion rate for women whose pregnancies – intended or not – occur in a stable, monogamous relationship. (Aside: the point here is not to throw stones. A public conversation about why we have difficult achieving monogamous relationships even when the vast majority of people desire them would also be helpful. We should be able to have a conversation about the problems of promiscuity without it simply be a stone-throwing contest, just as we can have conversations about the problems of drug use while not simply scapegoating individuals.)

The third issue to raise is the question of the long-term goal. Let’s say we have a system of effective contraception access and use, more comprehensive health care, somewhat higher restrictions on abortion availability – where will that get us? This is a description perhaps not far from the situation in Western Europe or (excepting the legal restrictions) among higher-income American women. Western Europe has the lowest abortion rate of any region in the world (about 12 per 1,000) and Guttmacher’s numbers suggest an abortion rate of about 14 per 1,000 for higher-income women. If we consider these numbers a kind of ideal-condition floor, let’s say the overall abortion rate dropped to 14 or even 12 in the U.S. – a stuation where we would have between 600,000 and 800,000 abortions every year. It would be hard for anyone to suggest that we had reached a point where abortion is “rare” with these kinds of numbers. I’m not sure what proposals pro-contraception-availability advocates have to lower the rate any further than this. I suppose “long-acting” birth-control methods, which reduce error rates, are the key ones. However, I think this is also a situation where we again have to talk about sexual behavior and say that avoiding risky – and perhaps the better term is “promiscuous” – sexual behaviors is a necessary and reasonable part of reducing abortions and even unintended pregnancies.

One way to consider a mature, reasonable public conversation on this issue would be for Catholics, while not requiring any change in magisterial teaching, to admit that it is plausible in a pluralistic society to view contraception as a legitimate public health and welfare issue. Insofar as Catholic tolerate legal contraception availability (which it seems we do) and do not attempt to criminalize officially immoral sexual behaviors (which we do not), there is a space for real conversation. One might here consider the "gradualism" indicated in Pope Benedict's well-know remarks in his Light of the World interview. But correspondingly, folks like the Guttmacher Institute could admit that public discouragement of promiscuous sexual behavior should be a necessary part of their aim to reduce unintended pregnancies. There are many corresponding cases where social changes in behavior really do happen by strong discouragement. Publicly discouraging promiscuity is at least as important as, say, public discouraging of tobacco use, and just as the glamorization of tobacco use in movies was subject to very strong backlash, so too might the same be done in popular culture for promiscuous sexual behavior. To make another comparison, the glamorization of promiscuity can be criticized with the same weight given to those who speak out against denigrating media portrayals of women and African-Americans – like these, it is not a matter of passing laws but of changing what we deem as acceptable. A bridge-building conversation would be one where we had both, not just one or the other.

Comments

One way to consider a mature, reasonable public conversation on this issue would be for Catholics, while not requiring any change in magisterial teaching, to admit that it is plausible in a pluralistic society to view contraception as a legitimate public health and welfare issue. Insofar as Catholic tolerate legal contraception availability (which it seems we do) and do not attempt to criminalize officially immoral sexual behaviors (which we do not), there is a space for real conversation.

My view is that the church's contribution to that conversation is to cheer the good public health outcomes while deploring the use of contraception in bringing about those public health outcomes; and to teach that adherence to its moral code - including living monogamous relationships, eschewing promiscuity and generously accepting children - is a holier way of living that also happens to bring about even better public health outcomes. This is, or should be, the status quo - would be the status quo if the church could find its voice and its nerve to talk about monogamy, promiscuity and the generous acceptance of children.

The problem of abortion is not because of promiscuity,in my opinon. In Europe young people are promiscuous but abortion rates are low.Neither is the problem one of access to contraception.Not to be glib, but really; people have abortions because they can. This is why wealthier women have more abortions then the poor. Because it's legal, an unintended pregnancy becomes a matter of evaluating whether one should continue with the pregnancy or not. If abortion were illigal for most of this population[wealthier, educated married women] abortion would not be thought of as necessary for the betterment of the woman or her family.For poor young and yes promiscuous women the truth is, that many if not most young poor women want to have babies. It is not an accident that in Europe where poverty as we know it here does not exist[the governement entilements are distributed more uniformly hence no stigma is attached to partaking of it] young promiscuous women don't want to have babies and abortion rates are low.The poor[here] want babies because when you're poor ,having a baby is a source of joyful anticipation;something to look forward to.The idea of having a baby is seen as a celebratory event in an otherwise disempowering life. Being a mother also gives status to a young empoverished girl.So many young empoverished and yes promiscuius girls want to get pregnant and will take a chance that the father of their child will accept the situation. Abortions rates are high among this group because ,since abortion is legal, young women give in to the demands of the father or other authority figures who convince them their lives will be hard and awful if they have a baby.The reality is ,however that these pregnancies are not unwanted, or even unintended by the young girl but she caves to pressure and has the abortion.But young women also know that it is culturally, politically incorrect to say they want to have a baby even though they're not sufficiently educated, have no job and /or, are engaged in promiscuous sex. Because it is not acceptable to say , that even under these circumstances they want to have a baby[which is natural to want when you're young and poor] they take their cue from the culture and give a narrative about unintended pregnancy and failure of the birth control to work. They know this is the only culturally acceptable narrative they can say as it deflects from having to justify how you could want a baby when you are poor.The culture does not understand or accept this. Saying you want to have a baby though you have no money, no education, no job ,no husband ,is not acceptable.They give a false narrative rather then own up to the timeless natural tendency of the poor to find joy in having babies.

people have abortions because they can. This is why wealthier women have more abortions then the poor.

I do think there is something to this. To take this to its logical conclusion, one would then expect that it will be decried as an injustice - another way inequality victimizes the poor! - that anyone has to pay anything at all for an abortion. I suppose sooner or later we'll be considering the wisdom of an HHS abortion mandate.

I'm a bit confused by why you think that proponents of contraception need to find a way to lower the abortion rate below the supposed floor. The unstated assumption seems to be that banning abortion would reduce the abortion rate below this floor, but Europe having a lower abortion rate than regions that do ban abortions implies that this is not true.

Rather than condemning contraception, perhaps the church needs to show how *traditional morality* is basically "divine common sense", i.e., demonstrate from a practical standpoint how abiding by God's rule/plan can prevent one's "getting into trouble" in the first place. This approach would not necessarily preclude *responsible* use of contraception if heterosexual marriage were acknowedged primarily as a means of companionship and not "baby-making".

My view is that the church's contribution to that conversation is to cheer the good public health outcomes while deploring the use of contraception in bringing about those public health outcomes; and to teach that adherence to its moral code ... is a holier way of living that also happens to bring about even better public health outcomes.

To put it midly, this is a bunch of pious bull-pucky. For my sensibilities, Mae West had it about right: "When I'm good, I'm very good. But when I'm bad I'm better."

I seem to remember that for clerics when it comes to having extra-celibate relationships or sexually abusing and exploiting children, priests and bishops don't seem to be overly concerned about "monogamous relationships, eschewing promiscuity and generously accepting children."

As the statistics cited above indicate, Catholics should advocate the use of contraception for all sexually active groups because it decreases rates of abortion - that is an intrinsically goodthing, as my moral philosophy professor used to say.

Besides, it would be a lot less hypocritical [to advocate for contraception] since the vast majority of Catholic women - like the rest of the population in general - use contraception. It's how we live in the 21st century.

Why make arbitary distinctions based on economic status? Contraception is just good public health practice - for especially women. [And, not just for reasons of contraception.]

If a slave owner in 1840 told you that at that time "that's just the way we live", I'm quite sure you wouldn't consider that a moral justification for slavery. So why is it OK to say, "Promiscuously is just the way we live. So that makes it OK"?

You're dodging the problem. And the problem is that unwed mothers on average have children who do not flourish in important ways, and promiscuity is part of the reason that they have children out of wedlock..

If a slave owner in 1840 told you that at that time "that's just the way we live", I'm quite sure you wouldn't consider that a moral justification for slavery. So why is it OK to say, "Promiscuously is just the way we live. So that makes it OK"?

You're dodging the problem. And the problem is that unwed mothers on average have children who do not flourish in important ways, and promiscuity is part of the reason that they have children out of wedlock..

The church can't encourage the use of sinful - evil - means even for a good end.

In our secular culture, many people believe that this is simply a public policy discussion. The church agrees it is a public policy discussion, but contributes to the discussion by insisting that the discussion actually is about the intersection of personal morality and public policy. The church claims that the personal moral dimension is critical to getting this right, and in fact, adhering to the church's moral teaching brings about good outcomes along both dimensions - the personal morality dimension and the public policy dimension.

Contraceptives are freely available in 7 of the 8 Catholic hospitals in Detroit, as the obnoxious "Vortex" person showed. All Catholics use contraception or condoms when required. The Mishnah and Talmud kept up an earnest debate on the rubrics of sacrificial rituals for centuries, long after these rituals no longer existed. I suspect that centuries from now Catholics will still be flogging this dead horse, as a talmudist badge of their identity!

Except that's not true. There are people who adhere to the contraception ban. Being married and adhering to the contraception ban isn't a theoretical construct; there are people today who are giving living witness to it. I'd think many of us can point to people - family members, friends - who have lived this way. My mother lived this way.

And of course, contraception within marriage is only one aspect of the matters under discussion. Humanae Vitae doesn't address the question of contraception use outside of marriage, but pregnancies outside of marriage apparently are a major contributor to the decision to abort. Statistics are presented in the very post to which we're commenting that a significant percentage of sexually active unmarried women don't contracept. The church has important things to tell them, too.

Joeph O'Leary, Christians have this weird impulse to "use Jews to think with." I think that taking away Christians' opportunity to use Pharisees as the bogeyman in arguments would be like taking away a baby's bottle. You are doing the same thing with th rabbis. The situations are not analagous, and it's insulting.

Ann Olivier: To paraphrase Mae West, "Promiscuity has nothing to due with it." You can always tell when a people are arguing from a weak position is when they use really bad analogies to either the Nazis, and/or to slavery. Contraception is not in any way comparable to the complete violation of human rights that chattel slavery based on racial biogtry was. Dodging? Really? Olivier you should know better that the "problems" facing the children of unwed mothers are both compound and multi-variate. Let's can all the bromides, please.

Jim Pauwels: Since facts seem to have little effect upon you, I won't go through all the struggle to get you to see the reality of women's reproductive rights and practice. While I'm sure your mother was indeed saintly, that was another place and time when women were socially and economically confined, to say the least. I'd like to meet some of these people "who are giving living witness to [it] - presumably you mean: "adhering to the contraception ban". In over thirty years of clinical practice I have never, never met a woman - poor or wealth - who chose to "abort" factored primarily on their marital status. Trust me Pauwels, a woman's decision to terminate a pregnancy is more complicated than than you would have us believe.

My argument isn't about slavery and contraception. Those topics were just examples to illustrate my argument. My argument is aboout your clearly expressed principle in defense of contraception or abortion that "it's how we live, so it's a better path". So how do you defend that principle?

The difficulty that the Catholic Church is having with sexual morality stems from it currently rules based. You take a checklist and answer a series of questions. If an act has all the right answers, it is good. If it gets one question wrong, it is bad.

This makes it impossible to adapt sexual morality to each new age. There are fundamental values, but these are filtered through practical realities as well as each age's prejudices. A renewed focus on what are the fundamental values of Christian sexual morality would help us sort this out and once again be able to make statements that are capable of persuading people. Pope John Paul II tried to do something along these lines with his Theology of the Body, but it failed because it was more concerned with maintaining the form of the existing structure than building a firm foundation.

Recently a group of German theologians published a critique of Catholic Church teachings on human sexuality and marriage, and proposed a new sexual understanding for the church. Their ideas may be a life-line that will help the hierarchs to climb out of the [human sexuality] ditch they've fallen into. We'll see ...

@ Ann Olivier: Apparently, unlike you Ann, I believe that there is an intrinsic moral validity to human development when the overwhelming, super-majority of humans adopt a certain way of thinking and behavior - not perfect by any means, but at least it is democratic. The "principle" that I would defend is called human biological, social, intellectual, psychological, political, etc. evolution. The hierarchs keep digging in that hole they've fallen into instead of embracing the inexorable march of evolution [which I would posit is actually the way, or modern understanding of the way that God speaks to us, how She speaks to us!

Hmm. Interesting. Sounds like a proto-natural law theory. You seem to think that a behavior can be *known* to be right when all you know is that everyone agrees that it is right. You're not saying that thinking makes it right, but universal thinking does make it *known* to be right.

But in a mature natural law theory general acceptance of a behavior is not enough to *show* that something is morally right or wrong. Understanding of *why* the super-majority accepts a certain behavio r is needed so as to reveal the goodness of that sort of action/inaction. It is always possible that the reason a whole people accepts a certain behavior or condemns a behavior might be and sometimes is purely a local reason and unreliable.

There are, I think, some problems with the foundations of the usual Thomistic natural law theory, so there's a good bit of room for discussion and argument about it. But I still think it's the best basic theory so far.

I think the data are compatible with the possibility that making contraceptives more available (via Obamacare) would reduce the abortion rate. The women who use contraception incorrectly, or formerly used contraception but stopped, often did so because of economic factors. Using the pill incorrectly often means skipping some days to "stretch" a pack of pills for a longer period of time, because it's barely affordable. Stopping taking the pill often occurs because some other expense meant that the woman simply could not buy her pills this month, or could not afford the co-pay on a doctor's visit to renew the prescription.

Mass incarceration of low income men, especially African-American men, is a huge part of the problem. It's asking a lot of women to achieve stable monogamy when something like a third of the potential husbands are either in prison or, in the case of African-American men with criminal records, essentially unemployable. (And it's important in justice to remember that low income African Americans routinely go to jail for offenses that affluent people are given a pass for. Both Rush Limbaugh and Cindy McCain committed drug violations that would have meant serious prison time for a person who could not afford expensive lawyers and expensive private rehab programs.)

I do think the Catholic bishops are out of touch with reality if they think their minimum wage hospital and university employees- including non-Catholic employees with no moral qualms about contraception- should be expected to practice abstinence or NFP and support any children that they have on $7.25 an hour.

I've been involved in a charity that helps abandoned street children in Romania. Why so many abandoned children? The former communist dictator, Ceaucesescu, banned both abortion and contraception in order to increase population size, while keeping the people impoverished. (Since he was a dictator, he was able to keep abortion truly rare: abortionists risked getting shot.) The result was a huge problem of parents abandoning children they could not support. This experience has taught me that a society CANNOT force parents to bear and care for children beyond what the parents can afford. If financially stressed people have not internalized the theology of the body in their heart- and most people have not- taking away their contraceptives will only lead to abortion or other forms of harm to children.

I went to a secular college and am very grateful that I didn't go to the Jesuit college next door. I took a couple of philosophy courses there and had many friends there, and I'm convinced that had I gone there I might not be Catholic today. The general (though not complete) lack of self-criticism was appalling, and I wanted nothing to do with the place.

Things have changed there, thank God, as they have in many of the old-style Catholic colleges. But there are still a few where self-criticism isn't included in academic life. The scary part is that the monied Catholics who support Catholic colleges generally seem to be mainly highly closed-minded people themselves, though I'm not absolutely sure of that. (Notre Dame gets a LOT of dough from Catholic donors. Maybe the Catholic liberals concentrate on it.) At any rate, money talks, and if rich Catholics quit giving because they don't understand the reason for academic freedom/self-criticism, then Catholic colleges are just as doomed as Catholic lower schools.

We'll see if Francis succeds in prying open the minds of the Catholic troglodytes, including those in the Vatican, and whether he inspires us all to more self-criticism. No self-criticism (and that includes criticism of the Faith as we understand it), no more Catholic schools..

Ann Olivier: If that Thomistic thinking works for you, knock yourself out. "Proto-natural law" is just to prescriptive for me.

The problem for the church: While Aquinas was certainly an advance for the church marrying its ethics with the Greek ancients' philosophy, it is that it has been stuck in that paradigm which assumes a static reality of the universe [pre-Coperican] always structured in constricting dualisms [good vs. evil] where there is a presumption of a deposit of universal truth [natural law] - unfortunately given the church's feudal patriarchal political structure it appropriated to itself the sole authority to discern what that is truth for the rest of us.

For me, I believe that reality is a social contruction where humans collectively are constantly discovering their truth in an ever evolving consciousness. Truth is product of a communal distillation process where the group over time - centuries really - come to consensus about what is real for them.

[For example: Evolutionists and biologists now talk about how "democracy" - a social contruction - is how social species decide when to migrate, where to go, nutritional choices, etc. And, we're not talking herd mentality here! Look it up.]

In this vision of human evolution, the Catholic hierarchy is a vestigial organ that no longer functions or contributes to the general welfare - thus, the clerics are shrinking in real terms every day. In our time, the People have surged ahead in their growing consciousness and understanding of what is meaningful [i.e., the Truth] about their own lived existence - all without the benefit or involvement of the hierarchs. [Isn't this what Ratzinger really meant when he would rant on about "moral relativism"?]

This is why the vast majority of women in general - Catholic women included - and growning numbers of men, have concluded that each woman is possessed of the right to reproductive freedom. Thus, humans have a right to circumscribe their reproduction and their expressed sexuality.

I know that this makes the hierarchs crazy. They're not in control anymore. History and culture has left them behind on the dust heap of history.

[Noticed yesterday the Vatican's narcissistic whinning reaction to the U.N. Committee on Children's scathing report on the sexual abuse and exploitation of children by priests and bishops. "How dare the U.N. tell us that our ethics and praxis is repressive and antiquatedm, needs to evolve!!!"]

I think there is a couple of fundamental flaws to this article's suggestions.

One way to consider a mature, reasonable public conversation on this issue would be for Catholics, while not requiring any change in magisterial teaching, to admit that it is plausible in a pluralistic society to view contraception as a legitimate public health and welfare issue.

The problem here is that this would require a change in magisterial teaching. The Church teaches that the willful act of contraception is an intrinsic evil. She also teaches that we may not do evil that good may come of it. Therefore, to embrace a notion that contraception can play a legitimate role in society would require the rejection of one or both other these megisterial teachings.

But correspondingly, folks like the Guttmacher Institute could admit that public discouragement of promiscuous sexual behavior should be a necessary part of their aim to reduce unintended pregnancies.

There are some advocates of contraception who really do see it as a way to reduce abortions. However, I don't think Guttmacher or Planned Parenthood can be included in their number. Guttmacher was formed when PP spun off their research arm in an attempt to give it more credibility. It may be a separate organization now, but the ideology remains the same. And we have to remember that PP is a business. It's business is abortion. While "98%" of it's services may not be abortion, abortion is it's #1 source of income. So it should not be surprizing that PP's other services actually foster its abortion business. Even it's contraception business fosters its abortion business. It focuses its contraception offerings on condoms and low-dose hormonal contraceptives, which are known to have higher failure rates when used properly and also have higher rates of improper use. They focus their contraception offerings on populations that their own research has shown to have higher rates of improper use, the youth and low-income populations. Their "sex ed" materials actually promote promiscuity and "experimentaion" and break down moral objections to sex outside of marriage. And then, when the contraceptives they promote fail the people who have bought into the culture they've created, PP is there with their abortion services.

All that depends on the notion that contraceptives lower the abortion rate. Every study that has been done has shown that the introduction of widespread contraception use raises the abortion rate in a society. It is only after the introduction of widespread contraceptive use has raised the abortion rate that mainstreaming of contraception and improvments in contraception use then reduces the abortion rate. But the abortion rate is still higher than it was before the introduction of widespread contraception use. The people who advocate for contraception as a means of reducing abortion alway focus on phase two, the decrease in abortion that results from improving contraception usage. They ignore phase one, the increase in abortion that results from introducing contraception into the society in the first place. We have to remember that since no form of contraception is perfect, contraception makes abortion a necesity.

The only way to reduce the abortion rate is to reduce sex outside of stable relationships that will welcome a child. A contraceptive culture fosters the opposite.

The reason that all the doctors on the Institute of Medicine panel recommended contraceptive coverage, including counseling, as an essential component of the Affordable Care Act is that 100% reliable contraception (e.g. implantable hormone delivery systems which provide continuously effective contraception for up to two years) is expensive. More affordable means of contraception are not nearly as reliable. The Washington University study showed the effectiveness of free and reliable contraception with respect to dramatically lowering unplanned pregnancy and abortion rates.

Native born Dutch in Holland have free abortion on demand yet have an abortion rate of 1/3 that of American Catholics. That speaks volumes about the relative effectiveness of contraception versus moral teaching in actually preventing abortions.

In Humanae Vitae, Pope Paul VI directly stated that lesser evils may be tolerated in some instances if they prevent greater evils. He then went on to say that contraception wasn't justified to prevent such things as family stress and bringing new children into situations of poverty. But he didn't consider the issue of contraception to prevent abortion.

It comes down to this: if you really are serious about preventing abortion on a population basis, you shouldn't stand in the way of efforts to educate and counsel young women in matters relating to contraception and stand in the way of efforts to make 100% effective contraception available to women who choose to take the opportunity to obtain this level of contraceptive protection.

The idea of making criminals of women and doctors who find themselves in the position of having to decide whether or not to terminate a given pregnancy is loathsome, compared to the alternative to providing contraceptives so that these women need never be faced with the need to consider whether or not to choose to have abortions.

I vaguely remember that contraception failed for about 1 out of 14 users. Is that the right figure these days? That would mean that out of 28 users, 2 would probably get pregnant. What are the figures these days, or are there any figures about probable failure?

Surely people ought to be given the odds of whether or not a method will work.

wineinthewater- I don't think your conclusion follows from your premises. Both Augustine and Aquinas said that a Christian society could tolerate an intrinsic evil if the results of prohibiting it were worse than the evil itself. (They were thinking of prostitution which they believed reduced the occurrence of rape.) A similar argument would say, since abortion is clearly a much, much graver evil than contraception, that people who are not converted to the Theology of the Body should be encouraged to contracept rather than abort.

Can you identify these studies that say that the introduction of contraception increases abortion? And what are these societies in which contraception is suddenly introduced, being previously unknown? Contraception is as old as history. Blocking the cervix with acacia gum (which is both sticky and somewhat spermatocidal) was used in anchient Mesopotamia. Coitus interruptus is as old as the Old Testament and was well known to the Greeks and Romans. Silphium and wild carrot were consumed to prevent pregnancy since Roman times (unfortunately, they were probably abortifacients, not contraceptives). Some of the herbal brews used in the Middle Ages as contraceptives were probably at least somewhat effective. Medieval manuals for confessors discussed when married women should be questioned about contraceptive practices, both herbal and withdrawal. The condom goes back to the 18th century.

Ann Oliver: the failure rate varies by method, and also there is a different failure rate for the "typical user" vs. the "perfect user". The most reliable method is the hormonal implant, with a 0.05% yearly failure rate. The IUD is also below 1%, but it is probably at least partly an abortifacient. The pill is 9% for an average user, but 0.3% for a perfect user. The diaphragm is 12% for an average user, but 6% for a perfect user. Condoms 18% typical, 2% perfect. Spermacide 28% typical user, 18% perfect user. (Since condom and spermacide are often used together, a little math gives us 5% typical, 0.4% perfect for the combo.) Withdrawal 22% typical, 4% perfect. These figures are from the Guttmacher Institute, but the failure rates for "typical" agree with those from the US Center for Disease Control. (Links: http://www.guttmacher.org/pubs/fb_contr_use.html, http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm)

I'm hopeful that the reliability of the pill will improve with Obamacare since many of the incorrect users were poor women stretching their pill supply by skipping some days which hopefully they will no longer need to do.

Hmm. Except for the hormonal implant, the odds of the other means for typical users don't look like they've improved. The pill fails in the typical user in about 1 in 10 cases. (You'd best check my math.) I'd call that quite high. Most of the other methods fail in almost 1 out of 5 cases for the typical users, which is twice as bad as the pill.

Looks like a great deal more R&D needs to be done before contraception can be considered even near reliable for most people.

Barrier methods aren't very reliable, because there is too high an incidence of "operator error."

Traditional oral contraceptives are reasonably reliable, but there is a failure rate, because the "operator" must take the pills faithfully, on schedule, and, in real life this doesn't invariably occur.

IUDs are very effective, but there is controversy concerning whether they work by preventing implantation or by increasing the thickness and viscosity of cervical mucous. The implantation prevention method is considered to be a type of abortion, according to Church doctrine.

The subdermal implantable hormone depot is even more effective than the IUD (in fact, it's virtually 100% effective - virtually the same pregnancy prevention rate as in the case of tubal ligation). It unambigously does NOT cause any type of abortion. It is fully reversible. The only downside is that it's expensive, which is why the doctors on the Institutes of Medicine panel recommended unanimously to make coverage for contraception a mandatory component of ObamaCare.

Thanks for the comments. I need to respond to wineinthewater and the story Holly Taylor Coolman posted. (1) Tolerating a lesser evil on a societal level has long-standing support in the Catholic tradition. It is presumably the status quo position for Catholics in societies where contraception is legal and widely available. (2) However, this does not solve the question of whether such toleration is prudent. My argument is that it is prudent, although such toleration should be accompanied by demands to include the problem of promiscuity in the social debate. While it seems difficulty to say that non-promicuous sex is the "only way" to reduce the abortion, I do think that it is the best way to reduce both abortion and and the problems for children of unstable family relationships, AND that sources like Guttnmacher ignore the problem of what I called the "floor" level of abortion that remains even after addressing issues of contraception availability, health care, etc. (3) Castigating Guttmacher because of its (obvious) agenda and connections to PP isn't really my point - in a sense, this is not much different than the tendency of some secular commentators to plug their ears against the Church because of the clergy sex abuse scandal. I wasn't suggesting that I buy wholesale into Guttmacher's claims that abortion restrictions have no effect - only that it is unclear to me how far such restrictions can go in addressing the problem if we can't have the larger conversation that I suggested.

1. To the article author- Please do not suggest using the demonization tactics of the anti-smoker movement for anything else. This is one of the most insidious and hateful propaganda campaigns against a group of people I have ever seen and should have never been allowed to go beyond common sense health warnings and education. Do we really want to stir up hatred against people who are promiscuous too?

2. As long as we live in a society that denigrates and devalues human beings by reducing them, and their relationships with each other, to market commodities, how can one think there is a way to reduce promiscuity within this context? That is what nobody will talk about.

3. Along those lines, how about the idea that the hedonistic pursuit of pleasure for its own sake is pointless and the end it leads to nothing but emptiness and pain? Have enough people thinking like that though, and our entire consumer economy collapses.

4. A truly intimate relationship with another person may or may not involve sexual relations and goes far beyond that in any case. In fact the very idea of an intimate monogamous permanent relationship flies in the face of our feel good, get what you can, never sacrifice anything for anybody else selfish society which we live in. Even the word intimacy has been cooped to mean a sexual relationship, and in a lot of cases a fleeting and meaningless one.

5. I had raised the Ceaucescu issue in another publication years ago - I asked if those who say abortion is the "only issue" during elections would have considered him to be pro-life and voted for him. Never heard back on that one.

6. I feel that the church makes a grave error in lumping abortion and contraception together. These are two very different things, and one at least to me is obviously a much graver issue than the other. But I do not get this sense of moral clarity from the church at all - rather what I take away from the church position is if someone prevents a life from being in the first place, it is the same as taking a life. I find this thinking morally repugnant and dangerous.

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About the Author

David Cloutier is associate professor of theology at Mount St. Mary’s University and editor of catholicmoraltheology.com. He is the author of Love, Reason, and God's Story: An Introduction to Catholic Sexual Ethics (2008) and is working on a book on the moral problem of luxury in contemporary economic ethics.